| NPI | 1417912858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WY 7560A) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 48232) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2020-07-22 |